Month: December 2011

According to the ADA the majority of bottled water does not contain optimal levels of fluoride to protect your teeth against harmful bacteria. In addition, some types of home water treatment systems also reduce the fluoride levels decreasing the decay-preventive effects of tap water. The absence of fluoride is not to be inferred as some kind of public or private ban on the use of fluoridation, because this is not the case. And with respect to your oral health, when used appropriately, fluoride is both safe and effective and probably your best means of preventing and controlling dental caries. So how do you use fluoride to achieve the maximum protection against dental caries and efficiently reducing the likelihood of enamel fluorosis? There are numerous fluoride modalities that are effective, inexpensive, readily available, and can be used in both private and public health settings. And if left unchecked, the resulting bacteria can penetrate dissolved surfaces, attack the underlying dentin, and reach the soft pulp tissue, causing of course tooth decay. Drinking fluoridated water, brushing with fluoride toothpaste, or using other fluoride dental products can effectively and inexpensively raise the concentration of fluoride in the saliva present in your mouth 100- to 1,000-fold.

Children and adults who are at low risk for dental caries can remain low risk through frequent exposure to small amounts of fluoride by drinking fluoridated water and using fluoride toothpaste. While children and adults at high risk for dental caries should benefit from additional exposure to fluoride by going one step further and utilizing mouth rinse, dietary supplements, and professionally applied products. The ADA reviews fluoride products for caries prevention through its voluntary Seal of Acceptance program and accepted products are listed in the ADA Guide to Dental Therapeutics. At this particular moment in our oral healthcare, fluoride is the only nonprescription toothpaste additive proven to prevent dental caries. As I have recommended in previous articles, brushing is the simplest and number one action you can take to maintain your teeth and oral hygiene. This of course should be followed by regular cleanings and checkups with your dentist.

There are few phrases that invoke as much fear and anxiety as these words from your dentist, “you need a root canal.” Where does this anxiety come from? In his state of the union address, President Obama said of the bail out, “I hated it. You hated it. It was as popular as a root canal.” Clearly, root canals are not very popular. The endodontist, a dentist who has two years of residency training in, among other things, performing root canal therapy, should be the least popular of all dentists. Yet if you have an all-consuming, head splitting toothache, the endodontist is the first person you want to and should see. An endodontist, with their advanced training, can relieve you of your toothache in one appointment. In this way, it would be better to understand endodontists as specialists in treating and preventing toothaches.

Inside of every tooth is tissue, called the dental pulp that helps the tooth grow and develop when the tooth is young. If the pulp comes in contact with bacteria through deep decay, a restoration, or a fracture, it can become damaged. In this way, toothaches are caused by inflammation or infection in the internal tooth, pulp, or surrounding bone. Antibiotics and anti-inflammatory medications will help control the symptoms but cannot resolve the problem. Root canal therapy, so named because the treatment takes place within the tiny roots of the tooth, is a procedure for cleaning and disinfecting the internal tooth structure. Think of it like having a very small filling deep in the tooth, so small that endodontists work with special instruments that are as small as a hair’s width in diameter and a microscope to help with vision. Typical treatment time depends on the complexity of the case and the number of roots within the tooth. Your visit can be anywhere from half-hour to two hours with longer treatments often divided into two separate visits for your comfort. In many respects, the experience will be indiscernible from having a filling.

Sometimes root canal therapy is indicated as a means to prevent an infection and toothache, which is why your dentist or endodontist may recommend root canal therapy on a tooth that has never caused any problems before. He or she is only looking out for your best interest, saving you from future discomfort and infection. Any time a tooth can be treated prior to infection, the procedure itself will be more predictable and easier on you, the patient.

Root canal therapy is a comfortable procedure. The treatment itself is performed under local anesthesia and there is no associated feeling. When it is over, you can often return to work or to enjoying your day. When people wince at the thought of a past root canal or describe a past experience, they are either referring to the toothache that caused them to need treatment, or were not under the care of a specialist who has advanced training, tools, and techniques. Sedation is offered in some offices, but it is not needed in the vast majority of cases. Patients, much to their own disbelief, very often fall asleep on their own during the procedure.

If you are referred to an endodontist for root canal therapy, there is nothing to fear. Your endodontist should make every effort to answer your questions and make the process as relaxing and comfortable as possible for you. If you have a toothache and are referred to an endodontist, know that you have already been through the worst part, you are heading to the right place, and treatment will have you feeling better quickly, often as soon as your endodontist numbs the area.

If you need additional information or have questions, this article was contributed to the Right Smile Center by Dr. Justin M. Parente of Alpharetta Endodontics, www.alpharettaendo.com (770-772-3002). Dr. Parente received his DMD and post graduate Endodontic specialty training at Medical College of Georgia and is a member of the American Association of Endodontists.

Many people are unaware of the consequences of losing their teeth or the effects of wearing partial or full dentures upon their jaws and bones. When teeth are lost, the surrounding bone immediately begins to shrink [atrophy]. Implant treatment, for tooth replacement therapy, can be the optimal treatment plan. Here are some important facts to take into consideration.

• Wearing dentures [plates] accelerates bone loss, and old dentures become loose because of this bone loss. It is possible to watch and wait for bone to disappear to the point where treatment success of any kind is in doubt.

• At the end of a five-year period, only 40% are still wearing the original partial denture made for them. This is not a great testimonial for value and utility. Those lucky enough to have a functioning partial denture after 5 years are still losing valuable supporting bone.

• Of those patients who wear a partial denture, 50% chew better without it.

• One study showed that after 8 years, 40% of the supporting teeth [abutments] that the partial hooks onto were lost through tooth decay or fracture.

• Patients with natural teeth can bite with about 200 pounds of force. Denture wearers can bite with approximately 50 pounds of force. Those wearing dentures for 15 years or more can bite with only about 6 pounds of force, and their diet and eating habits have had to been modified accordingly.

• The average lower full denture shifts from side to side during chewing and is a significant problem that new denture wearers must get use to and accept.

• Denture wearers have decreased nutritional intake, a ten year shorter life span, and 30% of denture wearers can only eat soft foods.

• The single tooth implant success rate is above 98%, and unlike a bridge, the teeth adjacent to the implant are no more at risk than if no teeth were missing.

• Implant-supported bridges or dentures have 95% success rates over 10 years without the severe loss of supporting bone.

For bone maintenance, the health of adjacent teeth, the longevity of the restoration and patient comfort, implant therapy is the treatment of choice. Implants can restore chewing function to the equivalent of someone with natural teeth. If you have questions or want to know if you are a good candidate for implant tooth replacement therapy, please call our office.

Our mission is to educate you about oral health and sometimes it’s a bit dry, but you need to know enough to participate in the decision making process. So…. here’s some of what you should know about implant brands:

Dental implants are made by various manufacturers, but the most widely used are:

Nobel Biocare – a leading company globally producing of dental bridges, implants and crowns. With their home office in Sweden, they offer a fully integrated line of implants, bridges and crowns for advanced techniques into tooth reconstruction-‘ providing dental professionals with state-of-the-art evidence-based tooth-to-root solutions’.

Zimmer – based in Indiana, Zimmer is known for their innovative prosthetics and regenerative products. They offer implants of all types noted for their suitability in general practice, periodontitis, prosthodontics and oral surgery. Their most common brands include the Tapered-screw vented implant, Hex Lock Contour Abutments and one piece implants.

Biomet 3i – Based in Florida, Biomet 3i offers a very comprehensive line of dental implants as well as abutments. Their technologies also ensure adequate site preparation and some regenerative products. BIOMET 3i pioneered the development of biologically driven dental implants, and

Straumann – based in Massachusetts, the Straumann Group focuses on oral tissue regeneration technologies and products as well as restorative dentistry, including implants. Their focus is creating techniques and technologies to encourage optimal tissue regeneration to implant technologies.

Major dental implant manufacturers as those listed above offer innovative and unique solutions for a variety of dental problems, approaches to care, technology and development. Additional dental implant manufacturers, such as Astra Tech, BioHorizons, Implant Innovations and CenterPulse also offer unique technologies and materials in the field of dentistry.

Patients seeking dental implants should not only research providers and techniques that suit their needs, but the source of materials and innovations used to receive the best in quality, experience and effective dental care. And if there’s a large discrepancy in price, your dentist may be sacrificing quality. The internet is no substitute for a qualified dentist but it can offer up-to-date information and resources regarding dental providers, like prosthodontists, trained and experienced in using the latest technologies and materials for dental implants. If we can be of any help please feel free to contact us for a complimentary evaluation.

Good oral health involves more than just brushing. To keep your teeth and mouth healthy for a lifetime of use, there are steps that you should follow. Here’s what you should consider:

1. Understand your own oral health needs.

Talk with your dentist, other oral health care specialist, or hygienist about any special conditions in your mouth and any ways in which your medical/health conditions affect your teeth or oral health. For example, cancer treatments, pregnancy, heart diseases, diabetes, dental appliances (dentures, braces) can all impact your oral health and may necessitate a change in the care of your mouth and/or teeth. Be sure to tell your dentist if you have experienced a change in your general health or in any medications you are taking since your last dental visit.

2. Develop, then follow, a daily oral health routine.

Based on discussions with your dentist, other oral health care specialist, and hygienist and considering your unique general health and oral health situations, develop an oral health routine that is easy to follow on a daily basis. For example, people with special conditions – such as pregnancy, diabetes and other underlying diseases, orthodontic appliances – may require additional instruction and perhaps treatments to keep their mouth healthy. Make sure you understand the additional care and/or treatment that is needed, commit to the extra tasks, and work them into your daily health routine.

3. Use fluoride.

Children and adults benefit from fluoride use. Fluoride strengthens developing teeth in children and prevents tooth decay in both children and adults. Toothpastes and mouth rinses contain fluoride. Fluoride levels in tap water may not be high enough without supplementation to prevent tooth decay. Contact your water utility to determine the level for your area. Talk with your dentist about your fluoride needs. Ask if fluoride supplements or a higher strength, prescription-only fluoride product is necessary for you.

4. Brush and floss daily.

Brush your teeth at least twice a day (morning and before bed time) and floss at least once a day. Better still would be to brush after every meal and snack. These activities remove plaque, which if not removed, combines with sugars to form acids that lead to tooth decay. Bacterial plaque also causes gum disease and other periodontal diseases.

5. Eat a balanced diet and limit snacking.

Eat a variety of foods, but eat fewer foods that contain sugars and starches (for example, cookies, cakes, pies, candies, ice cream, dried fruits and raisins, soft drinks, potato chips). These foods produce the most acids in the mouth, which begin the decay process. If you must snack, brush your teeth afterward or chew sugarless gum.

6. If you use tobacco products, quit.

Smoking cigarettes or using smokeless tobacco products increases your risk of oral cancer and cancers of the larynx, pharynx and esophagus; gum disease; as well as causes bad breath, tooth discoloration, and contribute to other oral and general health problems.

7. Examine your mouth regularly.

Become familiar with the appearance of your own mouth and teeth through frequent examination. This way, you will be able to catch any changes at an early stage and have these changes examined by a dentist. Look for the development of any spots, lesions, cuts, swellings, or growths on your gums, tongue, cheeks, inside of your lips, and floor and roof of your mouth. Examine your teeth for any signs of chipping or cracking, discoloration, and looseness. If you experience a change in your bite or develop pain, call your dentist as soon as possible. An oral examination is particularly important to conduct if you are a tobacco user, since you are at an increased risk of developing oral cancer.

8. Visit your dentist regularly.

The standard recommendation is to visit your dentist twice a year for check-ups and cleanings. Talk with your dentist about the frequency that is best for you considering your oral health situation.

Don’t be afraid to ask your dentist for more information if you don’t understand a treatment or procedure. You should be able to have a free and frank discussion with your dentist about the following types of issues:

What are the treatment options for a particular dental condition?

How do these options differ in cost and in their durability?

Do all the options solve the problem? What are the benefits and drawbacks of each option?

Of the dental treatments being recommended, which are absolutely necessary, which are less urgent, which are elective, and which are merely cosmetic?

What are the consequences of delaying treatment?

How much will the treatment cost?

When is payment due?

What method of payment does your dentist expect?

Do you have a clear understanding of all fees and methods and schedules of payment?